Discrimination and marginalisation destroy a culture’s strength and ability to participate completely in the life of society, and individuals’ health is impacted the most (Marmot, 2006). Considering the role of one’s social status and how it affects an individual’s sense of autonomy and participation in society, social environments have a powerful effect on health. Experiences with education, employment, financial security, childhood conditions and social participation (Marmot, 2005), have a direct effect on mortality, morbidity and risk factors for chronic illness.

Allostasis is an adaptation to stress, it involves alteration of the bodies neuro-endocrine system. This may be adaptive or protective in short-term effects however has detrimental long term effects on immunity, release of stress hormones, endocrine responses and metabolic systems. Active allostasis is seen through elevated levels of stress hormones, activated cytokines and hyper arousal of the nervous system. Allostatic load is the cumulative effects of stress related responses on multiple systems of the body; cardiovascular, endocrine, immune and cognitive function. With repeated stress and a consequent higher allostatic load there is dysregulation of blood sugar levels, mild cognitive impairment, heightened anxiety, amygdala enlargement, reduction of function of the pre-frontal cortex and atrophy of the hippocampus (McEwan, B. 2005).

Overall, the Allostatic load is the biological pathway through which ongoing stresses of social exclusion, disempowerment, discrimination, marginalization, lack of autonomy and economic disadvantage manifest into physical illness. This results in the increase in burden of disease for Indigenous people. Strategies and policies to improve access to culturally appropriate and informed health care, the incorporation of cultural protocols, changing the social views towards health, systemic restructure of the biomedical model and addressing the social determinates of health may partway assist the reduction of the physical response we see with Allostasis. This pathophysiological pathway is subtle but detrimental, and we need to provide support to reduce it.

Reducing Allostatic Load will provide the ability to have a further positive impact on the burden of chronic conditions such as diabetes.

By Trent Lyon

Exercise Physiologist

First Nations Health Unit